• Korea Journal of Hospital Management
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• v.19 no.4
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• pp.57-68
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• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• The Korean Journal of Emergency Medical Services
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• v.24 no.1
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• pp.25-36
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• 2020

Purpose: We analyzed the characteristics and differences in patients' medical benefits and health insurance based on disease severity classification. Methods: We examined 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included the Korean Triage and Acuity Scale (KTAS) classification of emergency and non-emergency situations ratio and type of insurance. Results: According to KTAS classification, 76.2% of patients exhibited an emergency condition and 23.8% exhibited a non-emergency condition. Emergency patients exhibited more trauma than non-emergency patients. According to the type of insurance coverage, the duration of stay in the emergency room was longer for patients with medical care than for patients with health insurance. Additionally, 119 ambulances use was significantly higher among patients with medical care. Conclusion: Policy discussions should address alternative ways to replace the 119 ambulances used by patients in this study. Additionally, health care administrators should identify alternative care agencies as potential alternatives to emergency room visits.

• Health Policy and Management
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• v.12 no.1
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• Journal of Korean Public Health Nursing
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• v.15 no.1
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• pp.56-72
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• 2001

Community mental health management system emphasizing on the rehabilitation and the return to the community has been established and carried out for many years. The study has been demanded to prove that the decreasing rate of the recurrence of the mentally ill resulted to lower their medical costs, to enrich the quality of life, and to reduce the psychological burden of their family. This study tried to prove that the mental health services to the mentally ill which were registered in community mental health center of A city have an influence on the medical cost, the quality of their lives. the family burden. The subject group of this study were 39 home-based mentally ill patients and their 37 family members, totally 76 people registered in mental health center of A city and participated in its program. This research had been measured twice, the first before the intervention and the second after at least a year. The measuring tools in the research were the medical cost measurment tools developed by the researcher, the quality of life index by Yoo ja, Noh(1988) and the family burden by Montgonery(1985). The methods were modified and supplemented in this study. This research made use of SPSS Win 10.0. The results of this study are the same as followings. 1) There were the significant difference in the medical cost before and after the mental health service delivery. 2) The quality of lives of the mentally ill, after the mental health services delivered were significantly higher than before. 3) The family burden were significantly reduced after the delivery of community mental health services. Community mental health services brought out efficient results to the social return and rehabilitation. And these results means that the mentally ill changed highly the quality of life and their burden of family and medical cost were reduced. So the public organization and the private society should help positively the mentally ill and their family through mental health policy and social service agency to live healthy lives and to be valuable member of society.

• Journal of the Korean Society for information Management
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• v.26 no.3
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• pp.435-449
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• 2009

Rapid change in information use environments that corresponds with the development of new technologies requires a new perspective in examining information source uses and information services. As understanding information seeking behaviors is an essential element for improving information services, the changing information seeking behaviors should be examined in a timely manner. While several prior studies focus on this topic, few studies deal with medical doctors' information seeking behaviors especially focusing on information seeking in both medical practices and research. Thus, this study aims to explore the information seeking behaviors of medical doctors who are both medical practitioners and researchers. Data were obtained by open-ended and semi-structured in-depth interviews during one month from April to May, 2009. The interview-question topics ranged from research contexts, medical-practice-related information seeking behaviors, favorable information sources, and information search process and satisfaction. Findings include that, for research purpose, digital journal articles accessed through the PubMed were more favorable sources while, for practice purpose, printed textbooks were preferred. Overall, the most-frequently-used sources were PubMed and articles because medical doctors regard the reliability and authority very highly.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.28-40
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• 2018

Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

• Journal of Information Technology Services
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• v.7 no.2
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• pp.113-125
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• 2008

To test if the developed ubiquitous health care devices working well and vital information could be collected and monitored systematically through internet and to test if the devices and services could be used further. Kyungwon University, KT Co., Gil Medical Center, LIG Nex1 Co., and Sujeong Health Center conducted an ubiquitous health care demonstration project in Sujeong-Gu, Sungnam, Korea from Mar. 5 to May 16. We developed and applied several medical devices to monitor health of the elderly in their houses through internet. The devices were sphygmomanometer, glucometer, body fat scale, Health Pad, and activity sensor. We distributed the devices to 20 recipients of home care and 7 diabetes patients. After received the devices and were explained how to use them, they used the devices in their houses. The vital signs of the residents were monitored through internet. A nurse monitored and consulted their vital signs in the monitoring center in Kyungwon University during the demonstration period. The consultant called them and consulted on their blood pressure, blood sugar level, and body fat after a few seconds they used the devices as well as provision of recommended contents such as diets and activities through Health Pad. To investigate cognition and satisfaction of the participants for the devices, we surveyed the participants at the end of the demonstration period. For the change in blood pressure, blood sugar level, and activities, we conducted statistical test. After the demonstration period. cognition and satisfaction for the devices and change in blood pressure, blood sugar level, and activities were evaluated. Most of the participants were acknowledged how to use the device and satisfied with the use of the devices. The internet monitoring and services are considered to be promising because most of the participants were satisfied especially because somebody was monitoring their health status. However some weaknesses such as short battery life of the activity sensor, lack of connection of consultations with hospitals, and low understanding on usage of some of the devices need to be complemented.

• 한국방재학회:학술대회논문집
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• 2008.02a
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• pp.143-146
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• 2008

This study aimed to suggest the way to support flood disaster older survivors with analysing how relief services and their human resources are used. For this study, the data was collected from 184 elderly aged over 65 years from Inje and Pyungchang in Gangwon province where lots of flood damages were done. The results of the study was elderly used human resources of public servant/military soldiers, volunteers as public or official services than as private resources. These results provide the evidence that public or official human resources are very helpful to control their emergency situations because there is hardly any use of their private human resources except for assistance from their family. And it shows that older people are willing to use services of life rescue and information services of their family members safety rather than basic supplies, medical care or medicine providing. With this findings we suggest informing the news of family safety including basic necessaries are highly signigicant. Thus, it is useful for disaster planners to understand building immediate life rescue and accurate information delivery systems. These are relevant to older adults' psychological well-being, thus, providing news of family safety including offering material resources are highly needed for older disaster survivors.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.23-36
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• 2021

Purpose: The purpose of this study was to determine how the use of level D personal protective equipment (PPE) and cardiopulmonary resuscitation (CPR) feedback equipment affects chest compression (CC). Furthermore, this study provides basic data for developing Korean CPR guidelines that can be applied to patients with suspected or confirmed COVID-19. Methods: This randomized, single-blinded, crossover simulation trial included 26 student paramedics who performed 2-minute chest compressions using three different methods: Method A involved performing traditional CC for two minutes without donning level D PPE, Method B involved performing CC while donning level D PPE, and Method C involved performing CC with a CPR feedback device while donning level D PPE. Results: The use of a CPR feedback device during the 2-minute CC increased the exercise intensity of the subjects, but donning level D PPE didn't affect the quality of CC and the exercise intensity. The results of methods A and B showed changes in the quality of compression 80 seconds after the start of CC. No significant changes occurred in 2-minute CC when using the CPR feedback device. Conclusion: Using a CPR feedback device could prevent deterioration in the quality of CC while donning level D PPE.

• Journal of the Korea Institute of Information Security & Cryptology
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• v.20 no.6
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• pp.251-260
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• 2010

Through the convergence of medical services and the IT technique, the patient's personal health information computerization has been rapidly spread with propagation of electronic medical record(EHR). In addition, by entering u-health, the demand of the secondary use for public health, medical research, and medical service using electronic patient health care records are increasing. The personal health information secondary uses for the development of academic medical area and service, are very good thing. But, carelessly to use personal health information, the patient privacy would be damaged. However, there are not yet systematic studies about secondary use of personal health information. Therefore, in this paper, we analyze the difference of the internal and external bill for personal medical data secondary use and propose the direction of the medical service development and preservation of the individual's privacy.